Socioeconomic inequities in invasive cardiac procedures after first myocardial infarction in Finland in 1995

J Clin Epidemiol. 2004 Mar;57(3):301-8. doi: 10.1016/j.jclinepi.2003.07.010.

Abstract

Objective: We examined socioeconomic disparities in coronary procedure rates after first events among hospitalized myocardial infarction (MI) patients.

Study design and setting: Information on MI patients in 1995 in Finland was obtained from the Finnish Cardiovascular Disease Register Project. Data on comorbidity, invasive treatments, hospitalizations, mortality, and socioeconomic status were obtained by linking data from the Finnish Hospital Discharge Register, cause of death register, population census, and the health insurance register using personal identity numbers.

Results: In 1995, 5172 patients aged 40 to 74 years were hospitalized for first MI. This corresponds to age-standardized event rates of 354/100,000 for men and 152/100,000 for women. Within 2 years, 33% of men and 21% of women underwent an invasive coronary procedure. Men in the lowest income third underwent 25% (95% confidence interval [CI] 12-36) fewer procedures than men in the highest third. Among women, the corresponding difference was 43% (95% CI 24-57). These disparities persisted throughout the 2-year follow-up, and they were not reduced by adjustment for comorbidity or hospital district.

Conclusion: Socioeconomic disparities were observed in receipt of invasive cardiac procedures. More attention should be paid to equitable distribution of scarce health care resources.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Censuses
  • Female
  • Finland / epidemiology
  • Health Care Rationing / methods
  • Health Care Rationing / statistics & numerical data*
  • Hospitalization / statistics & numerical data
  • Humans
  • Income
  • Male
  • Medical Record Linkage
  • Middle Aged
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / surgery*
  • Myocardial Revascularization / statistics & numerical data*
  • Social Justice
  • Socioeconomic Factors